How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $67.61 Median $1,737.80 Typical High $7,762.47 | Facility | None | $67.61 | $1,737.80 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $70.79 Typical High $100.00 | Professional | None | $45.71 | $70.79 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $61.66 Typical High $75.86 | Professional | None | $34.67 | $61.66 | $75.86 |
BCBS Kansas Setting Facility Modifier None Typical Low $42.66 Median $346.74 Typical High $371.54 | Facility | None | $42.66 | $346.74 | $371.54 |
BCBS Kansas Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $93.33 | Professional | None | $66.07 | $66.07 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $173.78 Typical High $389.05 | Facility | None | $46.77 | $173.78 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $77.62 Typical High $107.15 | Professional | None | $50.12 | $77.62 | $107.15 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $380.19 Typical High $15,135.61 | Facility | None | $87.10 | $380.19 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $338.84 Typical High $478.63 | Professional | None | $72.44 | $338.84 | $478.63 |
United Setting Facility Modifier None Typical Low $125.89 Median $398.11 Typical High $1,778.28 | Facility | None | $125.89 | $398.11 | $1,778.28 |
United Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $100.00 | Professional | None | $53.70 | $70.79 | $100.00 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $34.67 Typical High $50.12 | Professional | 52 · Reduced service | $22.91 | $34.67 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $14.13 Typical High $19.95 | Professional | 53 · Discontinued | $9.12 | $14.13 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $52.48 Typical High $75.86 | Professional | 54 · Surgery only | $33.88 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.47 Typical High $15.14 | Professional | 55 · Aftercare only | $6.76 | $10.47 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $7.08 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.57 | $7.08 | $10.00 |
Where Kansas sits
The same service costs 4.2 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Kansas· 14th of 51
$87.10
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.